|
Drng of palm single bursa 26025
|
$819.88 |
$819.88 |
$2,444.37 |
$3,839.54
|
|
Drng of pelvic abscess transrectal 45000
|
$3,070.50 |
$3,070.50 |
$3,070.50 |
$2,295.30
|
|
Drng of salivary cyst 42409
|
$3,575.45 |
$3,575.45 |
$3,575.45 |
$3,819.23
|
|
Drng of scrotum abscess 55100
|
$625.10 |
$625.10 |
$1,811.72 |
$1,997.89
|
|
Drng open retroperitoneal abscess 49060
|
$781.20 |
$781.20 |
$781.20 |
$1,924.00
|
|
Drng peritoneal abscess open 49020
|
$938.88 |
$938.88 |
$938.88 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$226.45 |
$226.45 |
$1,710.96 |
$2,039.50
|
|
Drng salivary gland submax/subling 42310
|
$93.80 |
$93.80 |
$573.64 |
$799.40
|
|
Dronabinol 2.5mg oral
|
$0.39 |
$0.39 |
$0.39 |
$17.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$0.14 |
$0.14 |
$34.85 |
$31.25
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$2,275.80 |
$2,275.80 |
$5,209.23 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$1,575.70 |
$1,575.70 |
$1,575.70 |
$119.50
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$27.00 |
$27.00 |
$27.00 |
$53.60
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$2,071.01 |
$2,071.01 |
$2,071.01 |
$193.15
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$280.18 |
$280.18 |
$280.18 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$321.43 |
$321.43 |
$4,810.58 |
$7,465.97
|
|
Drug admin & hemodynmic meas
|
$446.85 |
$446.85 |
$446.85 |
$569.75
|
|
Drug assay caffeine
|
$95.32 |
$95.32 |
$95.32 |
$80.00
|
|
Drug assay posaconazole
|
$96.75 |
$96.75 |
$96.75 |
$96.75
|
|
Drug assay rufinamide
|
$100.32 |
$100.32 |
$100.32 |
$87.10
|
|
Drug assay vedolizumab
|
$337.20 |
$337.20 |
$337.20 |
$154.00
|
|
Drug assay voriconazole
|
$96.75 |
$96.75 |
$96.75 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$345.00 |
$345.00 |
$345.00 |
$66.43
|
|
Drug of abuse screen urine
|
$14.00 |
$14.00 |
$312.74 |
$67.89
|
|
Drug screening tapentadol
|
$3.68 |
$3.68 |
$95.93 |
$47.03
|
|
Drug screen quant tiagabine
|
$114.62 |
$114.62 |
$114.62 |
$107.59
|
|
Drug test def 15-21 classes
|
$402.75 |
$402.75 |
$402.75 |
$322.50
|
|
Drug test def 1-7 classes
|
$330.00 |
$330.00 |
$330.00 |
$263.25
|
|
Drug test def 22+ classes
|
$185.15 |
$185.15 |
$552.59 |
$426.24
|
|
Drug test def 8-14 classes
|
$298.34 |
$298.34 |
$298.34 |
$289.80
|
|
Drug test prsmv instrmnt
|
$211.75 |
$211.75 |
$345.68 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$141.93 |
$141.93 |
$1,041.00 |
$278.85
|
|
Drvvt confirm - quest
|
$18.73 |
$18.73 |
$140.54 |
$109.20
|
|
Dry needling (97799)
|
$180.95 |
$180.95 |
$180.95 |
$114.27
|
|
Dstrj extensive retinopathy
|
$3,041.24 |
$3,041.24 |
$3,041.24 |
$4,462.45
|
|
Dstrj nulyt agt gnclr nrv
|
$0.01 |
$0.01 |
$2,779.25 |
$2,980.00
|
|
Dstr mal les s/n/h/f/g >4.0
|
$664.50 |
$664.50 |
$664.50 |
$664.50
|
|
Dstr mal ls f/e/e/n/l/m2.1-3
|
$773.94 |
$773.94 |
$773.94 |
$603.20
|
|
Dstr mal ls f/e/e/n/l/m3.1-4
|
$542.62 |
$542.62 |
$542.62 |
$724.37
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$79.80 |
$79.80 |
$530.71 |
$886.40
|
|
Ductogram sgl duct
|
$346.42 |
$346.42 |
$346.42 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$338.83 |
$338.83 |
$338.83 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$134.48 |
$134.48 |
$134.48 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$499.38 |
$499.38 |
$499.38 |
$489.72
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$774.38 |
$774.38 |
$774.38 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$275.98 |
$275.98 |
$904.78 |
$904.78
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$23,767.23 |
$23,767.23 |
$23,767.23 |
$16,549.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$651.00 |
$651.00 |
$651.00 |
$8,445.90
|
|
Dxa bone density axl vrt fx
|
$293.20 |
$293.20 |
$293.20 |
$401.20
|
|
Dx bronchoscope/lavage 31624
|
$879.03 |
$879.03 |
$879.03 |
$2,446.60
|
|
Dx dark adaptation exam i&r
|
$319.04 |
$319.04 |
$319.04 |
$472.21
|
|
Dx duod intub w/asp spec 43756
|
$215.77 |
$215.77 |
$215.77 |
$1,075.20
|
|
Dx duod intub w/asp specs
|
$207.47 |
$207.47 |
$207.47 |
$1,406.58
|
|
Dx gastr intub w/asp spec
|
$187.56 |
$187.56 |
$187.56 |
$441.60
|
|
Dx gastr intub w/asp specs
|
$120.90 |
$120.90 |
$120.90 |
$308.70
|
|
Dx intraop epcar Ultrasound chd i&r
|
$624.88 |
$624.88 |
$624.88 |
$465.29
|
|
Dx intraop epicar car Ultrasound chd
|
$624.88 |
$624.88 |
$624.88 |
$558.11
|
|
Dx intraop thoracic aorta Ultrasound
|
$624.88 |
$624.88 |
$624.88 |
$558.11
|
|
Dx laryngoscopy newborn
|
$727.48 |
$727.48 |
$727.48 |
$658.00
|
|
Dx laryngoscopy w/oper scope
|
$35.70 |
$35.70 |
$4,439.50 |
$2,755.53
|
|
Dx ntrop epcr Ultrasound chd img acq
|
$624.88 |
$624.88 |
$624.88 |
$558.11
|
|
Ear and throat examination
|
$850.88 |
$850.88 |
$850.88 |
$602.63
|
|
Ear canal biopsy 69105
|
$30.80 |
$30.80 |
$4,064.47 |
$1,889.50
|
|
Ear cartilage graft
|
$5,686.18 |
$5,686.18 |
$5,686.18 |
$6,385.40
|
|
Ear irrigation 69209
|
$29.05 |
$29.05 |
$84.92 |
$154.70
|
|
Ecallantide injection
|
$29,917.98 |
$29,917.98 |
$29,917.98 |
$13,357.14
|
|
Ecg/1-3 leads/tracing only 93041
|
$31.68 |
$31.68 |
$160.28 |
$132.08
|
|
Ecg < 30 days transmission & analysis
|
$714.43 |
$714.43 |
$714.43 |
$412.88
|
|
Ecg external < 48 hours recording
|
$251.65 |
$251.65 |
$762.46 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$457.45 |
$457.45 |
$871.39 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$443.17 |
$443.17 |
$443.17 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$443.17 |
$443.17 |
$443.17 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$819.88 |
$819.88 |
$2,589.56 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$64.40 |
$64.40 |
$838.44 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$285.25 |
$285.25 |
$640.45 |
$511.55
|
|
Echocardiograpy doppler follow up/limited study
|
$547.57 |
$547.57 |
$547.57 |
$371.25
|
|
Echo exam of eye
|
$280.25 |
$280.25 |
$280.25 |
$143.75
|
|
Echo exam of eye
|
$401.77 |
$401.77 |
$401.77 |
$172.00
|
|
Echo exam of eye thickness
|
$107.10 |
$107.10 |
$107.10 |
$40.30
|
|
Echo exam of fetal heart
|
$943.49 |
$943.49 |
$943.49 |
$904.80
|
|
Echo exam of fetal heart
|
$569.48 |
$569.48 |
$569.48 |
$538.27
|
|
Echo exam of fetal heart
|
$429.87 |
$429.87 |
$429.87 |
$431.41
|
|
Echo exam of fetal heart
|
$328.97 |
$328.97 |
$328.97 |
$318.34
|
|
Echo exam uterus 76831-
|
$331.10 |
$331.10 |
$585.61 |
$561.00
|
|
Echograp trans r pros study
|
$85.58 |
$85.58 |
$617.85 |
$468.00
|
|
Echo guidance radiotherapy
|
$231.53 |
$231.53 |
$822.42 |
$812.00
|
|
Echo guide cardiocentesis
|
$269.33 |
$269.33 |
$269.33 |
$269.33
|
|
Echo guide for amniocentesis
|
$148.40 |
$148.40 |
$377.11 |
$455.57
|
|
Echo guide for artery repair
|
$360.68 |
$360.68 |
$512.15 |
$696.30
|
|
Echo guide for transfusion
|
$344.76 |
$344.76 |
$344.76 |
$332.39
|
|
Echo guide ova aspiration
|
$75.98 |
$75.98 |
$75.98 |
$174.20
|
|
Echo guide villus sampling
|
$298.77 |
$298.77 |
$298.77 |
$362.88
|
|
Echo stress
|
$640.68 |
$640.68 |
$3,004.21 |
$1,609.44
|
|
Echo tee cngntl wo ctrst probe plcmnt
|
$1,196.35 |
$1,196.35 |
$1,196.35 |
$751.34
|
|
Echo tee guidance
|
$1,638.53 |
$1,638.53 |
$3,967.40 |
$1,878.84
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,134.18 |
$1,134.18 |
$2,872.38 |
$1,913.60
|
|
Echo transesophageal
|
$913.34 |
$913.34 |
$913.34 |
$1,075.20
|
|
Echo transesophageal
|
$1,734.10 |
$1,734.10 |
$1,734.10 |
$1,650.00
|
|
Echo transthoracic
|
$1,155.18 |
$1,155.18 |
$2,646.00 |
$1,361.75
|
|
Echo transthoracic
|
$1,470.53 |
$1,470.53 |
$1,470.53 |
$1,052.40
|